Unusual combination of partial anomalous pulmonary venous connection with atrial septal defect, pulmonary tuberculosis and intraosseous lipomas

Partial anomalous pulmonary venous connection (PAPVC) is an infrequent congenital heart anomaly where the pulmonary veins deviate from their normal course and drain into superior vena cava on the right side of the heart instead of the right atrium resulting in abnormally excessive blood flow to the lungs and the right heart, ultimately leading to heart failure over time. This case report describes a 24-year-old female with a 2-month history of fever, loss of appetite, and generalized weakness. The patient's chest radiograph and High -Resolution computerized tomography (HRCT) scan showed findings consistent with Pulmonary tuberculosis and PAPVC. The patient was started on anti-tuberculosis therapy (ATT) for tuberculosis and sildenafil citrate for the resultant pulmonary hypertension and her symptoms resolved within 4 weeks. The patient was advised for transesophageal echocardiography (TEE), which she declined. This case report highlights the importance of considering all possible diagnoses in patients with a combination of unrelated diseases presenting with atypical clinical features. It also highlights the need for a multidisciplinary approach to managing patients with PAPVC and other complex congenital heart defects with coexisting tuberculosis and intraosseous lipomas.